Tuberculosis And Lung Damage: From Epidemiology To Pathophysiology, 2018 University of Pennsylvania
Tuberculosis And Lung Damage: From Epidemiology To Pathophysiology, Shruthi Ravimohan, Hardy Kornfeld, Drew Weissman, Gregory P. Bisson
Open Access Articles
A past history of pulmonary tuberculosis (TB) is a risk factor for long-term respiratory impairment. Post-TB lung dysfunction often goes unrecognised, despite its relatively high prevalence and its association with reduced quality of life. Importantly, specific host and pathogen factors causing lung impairment remain unclear. Host immune responses probably play a dominant role in lung damage, as excessive inflammation and elevated expression of lung matrix-degrading proteases are common during TB. Variability in host genes that modulate these immune responses may determine the severity of lung impairment, but this hypothesis remains largely untested. In this review, we provide an overview of ...
The Conundrum Of Indeterminate Quantiferon-Tb Gold Results Before Anti-Tumor Necrosis Factor Initiation, 2018 University of Massachusetts Medical School
The Conundrum Of Indeterminate Quantiferon-Tb Gold Results Before Anti-Tumor Necrosis Factor Initiation, Shahrad Hakimian, Yevgeniy Popov, Abbas Rupawala, Karen I. Salomon-Escoto, Steven Hatch, Randall Pellish
Open Access Articles
Background: Tumor necrosis factor alpha (TNFalpha) is a key cytokine in both the pathogenesis of inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) and the host defense against tuberculosis (TB). Consequently, anti-TNFalpha medications result in an increased risk of latent TB infection (LTBI) reactivation. Here, we sought to evaluate the factors affecting the results of QuantiFERON-TB Gold In-Tube (QFT-GIT) assay as a screening tool for LTBI.
Methods: We conducted an observational, retrospective study in patients with IBD and RA who underwent LTBI screening using QFT-GIT at UMass Memorial Medical Center between 2008 and 2016 prior to initiation of anti-TNF medications ...
Splenic Infarction: An Under-Recognized Complication Of Infectious Mononucleosis?, 2018 Saint Vincent Hospital
Splenic Infarction: An Under-Recognized Complication Of Infectious Mononucleosis?, Yan Li, Ann George, Sami Arnaout, Jennifer P. Wang, George M. Abraham
Open Access Articles
Splenic infarction is a rare complication of infectious mononucleosis. We describe 3 cases of splenic infarction attributed to infectious mononucleosis that we encountered within a 2-month period. We underscore the awareness of this potential complication of infectious mononucleosis and discuss the differential diagnosis of splenic infarction, including infectious etiologies. While symptomatic management is usually sufficient for infectious mononucleosis-associated splenic infarction, close monitoring for other complications, including splenic rupture, is mandated.
Exploring The Influence Of The Peer Educator Role On Physical Activity, Exercise Patterns, Physical Fitness, Daily Functioning, And Health Harming Habits In People Living With Hiv, 2018 Old Dominion University
Exploring The Influence Of The Peer Educator Role On Physical Activity, Exercise Patterns, Physical Fitness, Daily Functioning, And Health Harming Habits In People Living With Hiv, Stephanie Jen, Jacob Wait, Amanda Pedrazoli, Kenneisha Edmonds
Undergraduate Research Symposium
With the progression of standardized HIV treatment and antiretroviral drugs, the outcomes for people living with HIV (PLHIV) have improved from a death sentence to a manageable chronic disease. Although PLHIV are living longer than before, they experience multi-morbidities more frequently and earlier than persons without HIV. These morbidities, such as type-2 diabetes, cardiovascular diseases, and obesity, are associated with sedentary lifestyles. It is well-established in the research of the general population that regular physical activity is a health promotion behavior that can prevent and/or mitigate the onset and severity of chronic diseases. Also recent meta-analyses have linked exercise ...
Patient Perspectives On Adherence To The New Hepatitis C Antiviral Medications: ‘A New Lease On Life’, 2018 VA Connecticut Healthcare System
Patient Perspectives On Adherence To The New Hepatitis C Antiviral Medications: ‘A New Lease On Life’, Nicole M. Giordano, Anthony J. Brinn, Guadalupe Garcia-Tsao, Steve Martino
The Qualitative Report
This study explored patients’ perspectives about taking the new direct-acting antivirals (DAAs) for the treatment of Hepatitis C (i.e., sofosbuvir, simeprevir, ledipasvir/sofosbuvir, ombitasvir/paritraprevir/ritonavir and dasabuvir) to identify facilitators of medication adherence. The project was conducted using semi-structured interviews with 12 Veterans who successfully completed a treatment course on the new DAAs. The Veterans were recruited using purposive sampling. The data collected from the semi-structured interviews was analyzed using an adapted open coding method outlined by Auerbach and Silverstein (2003), with identification of relevant text sub-grouped into repeating ideas, and then creation of overarching themes and constructs ...
Implementation Of A Low-Cost Unna Boot Alternative As Adjunctive Treatment For Kaposi Sarcoma, 2018 Purdue University
Implementation Of A Low-Cost Unna Boot Alternative As Adjunctive Treatment For Kaposi Sarcoma, Alexander Robert Mills, Edith Tonui, Sonak Pastakia, Rakhi Karwa, Phelix Were
Engagement & Service-Learning Summit: Reciprocal & Sustainable Partnerships
There are 6 million people living with HIV; 70% reside in Sub-Saharan Africa (SSA). Furthermore, 1.1 million deaths occur due to opportunistic infections (OIs) that can be minimized with antiretroviral therapy. In Kenya, Kaposi Sarcoma (KS) is an especially debilitating OI that presents with dermatologic lesions; magnifying the stigma that patients with HIV face physically and psychosocially. Dermatology research is underway to determine the effectiveness of an unna boot (medicated, layered compression dressing) to speed the healing of these lesions with anecdotal success. Commercially available unna boot products are too expensive and not readily available in SSA. Clinicians from ...
A Sex-Positive Approach To Healthcare, And Truvada As Hiv Pre-Exposure Prophylaxis (Prep), 2018 University of Vermont
A Sex-Positive Approach To Healthcare, And Truvada As Hiv Pre-Exposure Prophylaxis (Prep), Michael Ohkura, Nicholas Bonefant, Michael D. Upton
College of Medicine Faculty Publications
Nationally, incidence of new HIV infections has hovered around over 50,000 per year and men who have sex with men (MSM) carry the largest burden. In Vermont, 56% of individuals newly diagnosed are MSM, with 25% of diagnoses among youth ages 13-24 years old. Despite the proven efficacy and approval of daily Truvada (emtricitabine + tenofovir) as Pre-Exposure Prophylaxis (PrEP) against HIV infection, provider understanding and awareness of its use has remained extremely limited in Vermont with last estimates at just over 9 providers familiar with PrEP (excluding UVM Student Health, Planned Parenthood, and UVM Medical Center infectious disease department ...
Characteristics Of Pediatric Antimicrobial Stewardship Programs: Current Status Of The Sharing Antimicrobial Reports For Pediatric Stewardship (Sharps) Collaborative, Chrstopher Mcpherson, Brian R. Lee, Cindy Terrill, Adam L. Hersh, Jeffrey S. Gerber, Matthew P. Kronman, Jason G. Newland
Manuscripts, Articles, Book Chapters and Other Papers
In response to the growing epidemic of antibiotic-resistant bacterial infections, antimicrobial stewardship programs (ASP) have been rapidly implemented in the United States (US). This study examines the prevalence of the Centers for Disease Control and Prevention’s (CDC) seven core elements of a successful ASP within a large subset of US Children’s Hospitals. In 2016, a survey was conducted of 52 pediatric hospitals assessing the presence of the seven core elements: leadership commitment, accountability, drug expertise, action, tracking, reporting, and education. Forty-nine hospitals (94%) had established ASPs and 41 hospitals (79%) included all seven core elements. Physician accountability (87 ...
Determinants Of Facilitated Health Insurance Enrollment For Patients With Hiv Disease, And Impact Of Insurance Enrollment On Targeted Health Outcomes., 2018 University of Nebraska Medical Center
Determinants Of Facilitated Health Insurance Enrollment For Patients With Hiv Disease, And Impact Of Insurance Enrollment On Targeted Health Outcomes., Renae Furl, Shinobu Watanabe-Galloway, Elizabeth Lyden, Susan Swindells
Journal Articles: Infectious Diseases
BACKGROUND: The introduction of the Affordable Care Act (ACA) has provided unprecedented opportunities for uninsured people with HIV infection to access health insurance, and to examine the impact of this change in access. AIDS Drug Assistance Programs (ADAPs) have been directed to pursue uninsured individuals to enroll in the ACA as both a cost-saving strategy and to increase patient access to care. We evaluated the impact of ADAP-facilitated health insurance enrollment on health outcomes, and demographic and clinical factors that influenced whether or not eligible patients enrolled.
METHODS: During the inaugural open enrollment period for the ACA, 284 Nebraska ADAP ...
Mozambique: Hiv/Aids, 2018 Augustana College, Rock Island Illinois
Mozambique: Hiv/Aids, Camila Davila
Global Public Health
Mozambique is a country located in Southeastern Africa near the Mozambique Channel and the Indian Ocean. The president of this nation is Filipe Jacinto Nyusi. The total population is 26, 573, 706 which is composed of mostly 99.68% Africans and other minorities. Its national language is Portuguese although most of the population speaks Emarkhuwa. Most of the population is Catholic and a few others include Muslims and Zionist Christians. Mozambique faces several challenges with malaria, poverty, malnutrition, HIV/AIDS, and illicit drugs. HIV/AIDS is a common health problem that targets the immune system and is transmitted through bodily ...
Evaluation Outcomes Of A Modified Early Warning System For Early Identification Of Sepsis In The Adult Population Requiring Acute Care, Gavin Mackenzie Turpin
Objectives: To examine the use of a Modified Early Warning System (MEWS) for sepsis identification and evaluate its effects on treatment and outcomes for those patients diagnosed with sepsis after admission, during their stay at an acute care facility.
Design: A retrospective chart audit was conducted on the electronic medical records (EMRs) of patients who developed, and were diagnosed with, sepsis post admission. Specifically, a retrospective separate sample pretest posttest design was used to examine the accuracy of the MEWS, differences in outcomes (ICU days, length of hospital stay, qSOFA Score and mortality rates), and treatment initiation time (fluid ...
Simulation-Based Training In Ebola Personal Protective Equipment For Healthcare Workers: Experience From King Abdulaziz University Hospital In Saudi Arabia, Jameel Abualenain, M. Al-Alawi
Emergency Medicine Faculty Publications
Background: Millions of Muslims from across the world gather annually to perform pilgrimage. This can import unusual communicable diseases such as Ebola. Communicable diseases with a high risk of mortality necessitate special training to master the required competency to avert transmission of infections. The efficacy of simulation-based training (SBT) has been shown in such circumstances. Objective: We sought to develop an SBT program in Ebola Personal Protective Equipment (PPE) for all healthcare workers (HCWs). Methods: We conducted a quasi-experimental study at the clinical skills and simulation center at the King Abdulaziz University. An interdisciplinary committee was formed to develop this ...
Sivcpz Closely Related To The Ancestral Hiv-1 Is Less Or Non-Pathogenic To Humans In A Hu-Blt Mouse Model, 2018 National Institute of Health
Sivcpz Closely Related To The Ancestral Hiv-1 Is Less Or Non-Pathogenic To Humans In A Hu-Blt Mouse Model, Zhe Yuan, Guobin Kang, Lance Daharsh, Wenjin Fan, Qingsheng Li
The HIV-1 pandemic is a consequence of the cross-species transmission of simian immunodeficiency virus in wild chimpanzees (SIVcpz) to humans. Our previous study demonstrated SIVcpz strains that are closely related to the ancestral viruses of HIV-1 groups M (SIVcpzMB897) and N (SIVcpzEK505) and two SIVcpz lineages that are not associated with any known HIV-1 infections in humans (SIVcpzMT145 and SIVcpzBF1167), all can readily infect and robustly replicate in the humanized-BLT mouse model of humans. However, the comparative pathogenicity of different SIVcpz strains remains unknown. Herein, we compared the pathogenicity of the above four SIVcpz strains with HIV-1 using humanized-BLT mice ...
Identification Of Unequally Represented Founder Viruses Among Tissues In Very Early Siv Rectal Transmission, Jian Chen, Yanqin Ren, Lance Daharsh, Lu Liu, Guobin Kang, Qingsheng Li, Qiang Wei, Yanmin Wu, Jianqing Xu
Characterizing the transmitted/founder (T/F) viruses of multi-variant SIV infection may shed new light on the understanding of mucosal transmission.We intrarectally inoculated six Chinese rhesus macaques with a single high dose of SIVmac251 (3.1 × 104 TCID50) and obtained 985 full-length env sequences from multiple tissues at 6 and 10 days post-infection by single genome amplification (SGA). All 6 monkeys were infected with a range of 2 to 8 T/F viruses and the dominant variants from the inoculum were still dominant in different tissues from each monkey. Interestingly, our data showed that a cluster of ...
Home-Based Pre-Exposure Prophylaxis (Prep) Services For Gay And Bisexual Men: An Opportunity To Address Barriers To Prep Uptake And Persistence, Steven A. John, H Jonathon Rendina, Christina Grov, Jeffrey T. Parsons
Publications and Research
Gay, bisexual, and other men who have sex with men (GBM) are disproportionately affected by the HIV epidemic. Despite the promise of pre-exposure prophylaxis (PrEP) in reducing HIV transmission risk, barriers for uptake and persistence exist. We sought to identify whether GBM in a nationwide cohort who have not yet initiated PrEP (n = 906) would prefer to get PrEP-related care from a primary care provider (PCP) compared to a specialist clinic or provider. We then sought to identify their level of interest and factors associated with preference for using home-based PrEP services (i.e., HB-PrEP), defined to participants as conducting ...
Planning An Innovation Marathon At An Infectious Disease Conference With Results From The International Meeting On Emerging Diseases And Surveillance 2016 Hackathon, 2017 International Society for Infectious Diseases
Planning An Innovation Marathon At An Infectious Disease Conference With Results From The International Meeting On Emerging Diseases And Surveillance 2016 Hackathon, John W. Ramatowski, Christopher Xiang Lee, Aikaterini Mantzavino, Joao Ribas, Winter Guerra, Nicholas D. Preston, Eva Schernhammer, Lawrence C. Madoff, Britta Lassmann
Open Access Articles
A hackathon is best described as an 'innovation marathon'. Derived from the words 'hacking' and 'marathon', it brings together multidisciplinary teams to collaborate intensely over a short period of time to define a problem, devise a solution, and design a working prototype. International scientific meetings are conducive to successful hackathons, providing an audience of expert professionals who describe challenges and ensure the proposed solutions address end-user needs. Collaborations with local organizations and academic centers are crucial to attracting complementary specialties such as IT advisors, engineers, and entrepreneurs to develop sustainable projects. The core process of first identifying and deconstructing a ...
Molecular Evolution Of Dengue Type 2 Virus In Thailand, 2017 Yale University School of Medicine
Molecular Evolution Of Dengue Type 2 Virus In Thailand, Rebeca Rico-Hesse, Lisa M. Harrison, Ananda Nisalak, David W. Vaughn, Siripen Kalayanarooj, Sharone Green, Alan L. Rothman, Francis A. Ennis
Dengue is a mosquito-borne viral infection that in recent years has become a major international public health concern. Dengue hemorrhagic fever (DHF), first recognized in Southeast Asia in the 1950s, is today a leading cause of childhood death in many countries. The pathogenesis of this illness is poorly understood, mainly because there are no laboratory or animal models of disease. We have studied the genetic relationships of dengue viruses of serotype 2, one of four antigenically distinct dengue virus groups, to determine if viruses obtained from cases of less severe dengue fever (DF) have distinct evolutionary origins from those obtained ...
Rapid Diagnosis Of Dengue Viremia By Reverse Transcriptase-Polymerase Chain Reaction Using 3'-Noncoding Region Universal Primers, 2017 University of Massachusetts Medical School
Rapid Diagnosis Of Dengue Viremia By Reverse Transcriptase-Polymerase Chain Reaction Using 3'-Noncoding Region Universal Primers, T. Mirawati Sudiro, Hiroaki Ishiko, Sharone Green, Ananda Nisalak, David W. Vaughn, Siripen Kalayanarooj, Alan L. Rothman, Boonyos Raengsakulrach, Jurand Janus, Ichiro Kurane, Francis A. Ennis
A reverse transcriptase-polymerase chain reaction (RT-PCR) method was developed as a rapid diagnostic test of dengue viremia. To detect dengue viruses in serum or plasma specimens, a pair of universal primers was designed for use in the RT-PCR. Using these primers, the 3'-noncoding region of dengue virus types 1, 2, 3, and 4 could be amplified, but not those of other flaviviruses, such as West Nile virus, Japanese encephalitis virus, and yellow fever virus, or the alphavirus Sindbis virus. The sensitivity of the RT-PCR assay was similar to that of a quantitative fluorescent focus assay of dengue viruses in ...
Fmt Placed By Colonoscopy: Systematic Review And Meta-Analysis, 2017 Department of Internal Medicine, Aurora Sinai Medical Center
Fmt Placed By Colonoscopy: Systematic Review And Meta-Analysis, Nadia Huq, Veena Kumaravel, Aboud Affi, Maharaj Singh
Journal of Patient-Centered Research and Reviews
Background: Fecal transplants are successful in the treatment of recurrent or refractory Clostridium difficile infections (CDI), but there is no consensus on the best method of instillation. Studies have shown greater success with lower gastrointestinal tract placement, but technical aspects of placement are not validated.
Purpose: This review aims to identify common traits and procedural techniques of successful fecal microbiota transplant (FMT) therapy via colonoscopy.
Methods: An electronic search was conducted using OVID Medline and PubMed for articles published from January 2010 to January 2016. The primary outcome of interest was cure by FMT placed via colonoscopy.
Results: Of the ...
Six-Year Experience Of Influenza Vaccination As A Condition Of Employment For A Large Regional Health Care System, 2017 Population Health, Aurora Health Care
Six-Year Experience Of Influenza Vaccination As A Condition Of Employment For A Large Regional Health Care System, John R. Brill, Mark Hermanoff, Angela Tonozzi, Mary Jo Capodice, Jennifer Farrar, Zarina Dawoodbhai
Journal of Patient-Centered Research and Reviews
Background: Influenza remains a significant contributor to morbidity and mortality in the United States. Health care workers (HCW) can be both victims and vectors of influenza. Influenza vaccination of HCW is protective for both caregivers and patients, but voluntary programs generally fail to achieve rates recommended by the Centers for Disease Control and Prevention. Despite a complex, multifaceted influenza program initiated in 1996 that included significant education and promotion as well as free on-site vaccination, annual Aurora Health Care caregiver immunization rates remained in the mid-70s until adoption of a “condition of employment” strategy in 2011.
Purpose: Discuss the annual ...